The joining of luminal structures in the body is a common and critical procedure in the field of surgery. Luminal structures in the body that may be joined using applicant's unique method and device include components of the vascular, biliary, and genito/urinary systems. Surgical procedures in which bodily luminal structures are joined are typified by the vascular anastomosis, for example, bypassing occluded or stenotic arteries in the leg or heart, repairing lacerated arteries in the wrist, or connecting free muscle flap to a new blood supply to cover exposed bones. Additional uses include, by way of example, reversals of vasectomies, ureteral transection repair, and hepatic duct injury repair.
In the past, the typical technique for joining luminal structures, particularly small blood vessels, is to carefully place interrupted, single sutures circumferentially in close proximity to each other around the ends of the luminal structures to be joined, and securing, such as by tying, the ends of the suture lengths. This is a tedious manual procedure in which the surgeon, using his hands and eyes, aided by magnifiers, carefully guides the needle, bearing the suture, through the delicate and fragile walls of the end of the blood vessel or other luminal structure. The surgeon uses only his eye as a guide and attempts to accurately circumferentially place a first set of sutures in an end of the luminal structure and a second set of suture ends in an end of the second luminal structure, such that the sutures on each end of the luminal structures are a matched set and will join up when the ends are brought together and the sutures tied. Compounding the problem of careful placement of sutures equal distance from one another circumferentially about a luminal end is the dimensions and composition of the luminal structure itself. It is typically quite small, in the range of 1 to 6 mm in diameter and floppy--that is, without rigid walls. Moreover, the surgeons must often join numerous sets of corresponding luminal structures.
What is needed, and has heretofore been unavailable, is a device and method for guiding the suture-bearing needles to ensure proper spacing and placement of the sutures through the walls of the luminal structures to be joined.
Applicant accomplishes this and other objects by providing a simple bridge for insertion into openings of the luminal structures to be joined, the bridge having guide means incorporated therein to guide the needle through the bridge and through the walls of the luminal structures to be joined.